The “Slow Medicine” Approach to Compassionate Care

More than 70 guests joined us to hear Dr. Dennis McCullough describe the “slow medicine” approach to compassionate care at DFA’s inaugural Elder Care Professional Lecture on April 29, 2011, at The Willows of Worcester.

Dr. McCullough emphasized the importance of slowing down medical decision-making in order to focus on our elders’ quality of life. A geriatrician with decades of experience, he advocated for taking a step back from crisis intervention, to first understand and observe our elders’ needs and silences at different stages of the aging process.

“We like to interpret our elders’ silence as denial,” writes Dr. McCullough in his book, My Mother, Your Mother: Embracing Slow Medicine, “but in my clinical experience there are life conditions and seasons elders clearly understand and recognize, even if they are not drawn to overt analysis.”

Describing the importance of observing and being sensitive to our elders’ needs, Dr. McCullough outlined the Eight Stations of Late Life as a way to understand the changes they are going through. Each station brings its own unique set of circumstances, and each stage requires us as caregivers to be accepting of the gradual process of letting go of life:

Station 1: Stability
When Mom tells you not to worry, everything’s fine. Whatever she’s dealing with, she wants to handle it on her own terms.

Station 2: Compromise
Dad tells you that Mom’s “having a little problem.” Maybe she’s having trouble remembering things. Or maybe there’s a bigger health issue surfacing that no one is yet willing to acknowledge fully.

Station 3: Crisis
She’s in the hospital after a fall or other medical emergency. The family is in shock.

Station 4: Recovery
Mom needs to go to a rehab center or nursing home to recover. The healing process takes weeks. She comes home weaker and unable to live on her own or with just Dad’s help anymore.

Station 5: Decline
Mom is ailing. She needs extensive help with personal care. As her health declines, she eventually needs some form of round-the-clock support.

Station 6: Prelude to Dying
Mom’s caregivers sense a change in her spirit. She seems to be preparing to let go.

Station 7: Death
The hospice nurse tells the family they need to come now.

Station 8: Grieving/Legacy
During the ensuing weeks, months and years, the family shares their loss and learns to cherish all that Mom gave to them throughout her life.

We all gained insights and inspiration from Dr. McCullough’s remarks and are grateful that he could help us to launch our professional lecture series. This lecture, sponsored by the new DFA Fund for Elder Care Education and Support, marks the 15th anniversary of Deborah Fins Associates.